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Simultaneously improving care while reducing cost is the daunting challenge facing our health system today. Let me tell you a story about getting the job done, and what it takes to do it:
The NYUPN Clinically Integrated Network ― a collaboration between New York University Langone Medical Center and the University Physician Network in Manhattan ― used Optum Performance Analytics to do a deep dive into its data. The findings indicated patients were too often seeking out-of-network care. This trend was undesirable for several reasons: the loss of care coordination; wasted resources because of duplicative tests and/or services by higher-cost providers; and potentially compromised patient outcomes.
NYUPN educated its physicians about the problem and the clinical and financial consequences of out-of-network care. Reports that drilled down to source data reinforced the message, and motivated doctors influenced their patients to stay in-network more often. The result? Network use went up 5 percent.
Health care is awash in data ― 30 percent of the world’s stored data are health care-related ― and that development represents an enormous opportunity. Hidden in the data are solutions to some of our health system’s most complex challenges: how to contain costs, shift to value-based care, meet consumer demands for transparency ― the list goes on and on. But too often, the data are stuck in silos ― potential insights just waiting to be tapped.
The question is self-evident: How do we realize that potential? At Optum, because we partner with clients across the health system, we’ve learned how to connect disparate data to reveal the meaning within. Our experience shapes and builds upon our health care intelligence ― what we call OptumIQ.
OptumIQ informs our products and services so that they maximize results for patients, providers and health plans alike. As NYUPN discovered, solutions with OptumIQ ― such as Optum Performance Analytics ― make a difference every day by enlightening possibilities, simplifying workflows and empowering our partners to take action.
This health intelligence foundation uses a three-pronged approach:
Data ― from EMRs, claims, consumer records and dozens of other sources ― are collected and stored in different ways. Some sources, such as physicians’ notes, are difficult to catalog through traditional methods. Standardizing and linking data is the first step towards usability.
To gain value out of the curated data, the next step is analytics. Optum solutions use tools such as artificial intelligence, machine learning, improved metrics and predictive modeling techniques to seek patterns in quality and outcomes, consumer behavior, cost, risk, and utilization and operational performance.
The human touch is critical. Optum harnesses the wisdom of over 26,000 technologists, data experts, clinicians, actuaries and public health professionals to explore insights and potential solutions from the analytic findings.
When data get freed and integrated cohesively, everyone in the health system benefits. Free-flowing data can help limit administrative waste, uncover innovative ways to manage chronic illness and simplify operations as well as help patients get access to the clinical and financial information they need.
Indeed, health data ― when properly linked and interpreted by health care experts using intelligent analytics ― can drive greater cost transparency, efficiency gains and better care for all.
Continue the conversation at HIMSS18. Visit us at Booth 6425.
Disclaimer: The views and opinions expressed on this blog or by commenters are those of the authors and do not necessarily reflect the official policy or position of HIMSS or its affiliates.